Provider Demographics
NPI:1417739822
Name:CHARIF PSYCHIATRIC CLINIC
Entity Type:Organization
Organization Name:CHARIF PSYCHIATRIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C0-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GULED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDIRAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-298-5176
Mailing Address - Street 1:7630 145TH ST W
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7553
Mailing Address - Country:US
Mailing Address - Phone:612-298-5176
Mailing Address - Fax:
Practice Address - Street 1:7630 145TH ST W
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7553
Practice Address - Country:US
Practice Address - Phone:612-298-5176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty